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Greece reports locally acquired dengue fatality - Update: Dengue ruled out

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
machinetranslation

sept 43 , 2012

Death from Dengue!

A 84-year-old from Agrinio died from dengue fever. The disease is transmitted by a mosquito format, which is not in Greece. The last epidemic had occurred in 1927-1928 and has since eradicated from our country. Scientists, however, believe that the virus may be transmitted by the tiger mosquito.

From the Center for Disease Control (KEELPNO) announced yesterday that her husband left her last breath last Thursday at a hospital in Patras, where hospitalized with hemorrhagic fever syndrome and septic shock.

In this patient there was laboratory evidence of recent infection with dengue fever. The disease manifests as a normal flu with fever, headache, myalgias, arthralgias, nausea, vomiting and rash, and in severe cases there may be thrombocytopenia and bleeding.

Dengue is the vast majority of cases self-limiting disease with mortality usually less than 1%. Groups at risk are the elderly, pregnant women and people with chronic diseases attendant.

Mosquitoes
Transmitted by mosquitoes of the species Aedes and particularly the mosquito Aedes agypti, which is not found in repeated studies during the past decade in our country. Epidemiologists note, however, that since 2003 has been in our country tiger mosquito (Aedes albopictus), which is considered as a potential transmitter of the virus. The virus is not transmitted from person to person.

In Europe in recent years have reported isolated cases of indigenous virus infection (in France and Croatia). Imported cases from areas where the virus is endemic (Southeast Asia, Africa and Latin America) are reported from many countries.

The possible entry of the virus in our country can come either by travelers (and immigrants) who are sick and are in phase viremia, which is likely, or entry of infected mosquitoes with transport.

DIM KARAGIORGOS

Ethnos

map1.gif
 
Re: Greece reports locally acquired dengue fatality

Re: Greece reports locally acquired dengue fatality

[Source: BBC, full page: (LINK).]

Death prompts Greece dengue scare

(September 4 2012)


An elderly man has died in Greece in what officials believe to be the country's first case of dengue fever since the 1920s. The man, in his 80s, died in hospital on 30 August after contracting fever in the western village of Agrinio.


(?)
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Re: Greece reports locally acquired dengue fatality

Re: Greece reports locally acquired dengue fatality

Epidemiological update: Possible local transmission of dengue virus in Greece, 6 September 2012

07 Sep 2012

ECDC
On 3 August 2012, a probable case of dengue infection was reported in a resident in west Greece (Agrinio). The 84 year old patient, who had severe underlying conditions and septicaemia, died on 30 August 2012. He had not travelled abroad to a dengue transmission risk area. The case has been classified as a probable dengue case due to the presence of a high titer of IgM dengue antibodies in a serum sample. In addition, dengue NS1 antigen was detected in serum with PCR but dengue nucleic acid tests were negative.


Dengue is a mosquito-borne disease caused by any one of the four types of dengue virus. Most infections occur in tropical regions with an estimated 50 to 100 million cases annually in 125 countries. There is no direct person-to-person transmission. The main vector of dengue worldwide, the Aedes aegypti mosquito, is not present in Greece. Aedes albopictus, an effective secondary mosquito vector known to cause outbreaks, has been present in western Greece since at least 2003. There is currently no information about its presence in the local area where the case lived.

Dengue infections are rare in Europe and most cases are imported as a result of infection in tropical areas. Local transmission of dengue virus is extremely rare in Europe. The last recorded local transmission of dengue virus in Greece was during an outbreak in 1927 – 1928 involving the Aedes aegypti mosquito. Autochthonous cases were reported by France and Croatia in 2010.

The Hellenic Centre for Disease Control (KEELPNO) has initiated epidemiological and entomological investigations which are likely to produce critical information for assessing the risk of local transmission of dengue. The investigations include active retrospective and prospective case finding, review of compatible cases, and a survey of people living within a 200 m radius of the case.

Clinicians and public health professionals in the area are being informed about the clinical presentation of dengue and the possibility of local transmission. Public awareness campaigns about personal mosquito protection are already ongoing as a result of West Nile virus transmission.

Although it may never be fully established to what extent dengue contributed to the patient’s death, the laboratory test results clearly indicate an acute dengue virus infection.

Introduction of dengue virus via infected travellers with subsequent local transmission is possible as demonstrated by the reports of local transmission in France and Croatia. The entomological investigation will provide further evidence of the presence of the Aedes albopictus mosquito in the area. Epidemiological investigations and serological surveys will provide information on whether dengue virus is circulating in the local population.

ECDC
 
Re: Greece reports locally acquired dengue fatality - Update: Dengue ruled out

Re: Greece reports locally acquired dengue fatality - Update: Dengue ruled out

From EPISOUTH

Location: Greece Event: Dengue (ruled out)

On 3rdOctober 2012, following the Hellenic Centre for Disease
Control and Prevention (KEELPNO) announced that the case
initially reported as a probable autochthonous dengue case on 3rd
September 2012
in the municipality of Agrinio (located in the
Aetolia-Acarnania regional unit of Western Greece, cf. eWEB
n?234) has been ruled out.

Additional laboratory tests have allowed ruling out dengue fever as
a diagnosis for this case.


Entomological investigation has confirmed the presence of Aedes
albopictus, a competent vector of dengue virus, in the area of the
patient?s residence, although reports of the presence of the
particular mosquito genus in the wider region exist since 2003.


In the 1920s, a large dengue outbreak
was reported in Greece, mainly in
Athens area. This was the last dengue
outbreak reported in Greece.
 
Re: Greece reports locally acquired dengue fatality - Update: Dengue ruled out

[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK).]

Epidemiological update: No local transmission of dengue virus in Greece

05 Oct 2012 / ECDC



The Dengue case reported in the epidemiological update of 7 September has now been discarded based on additional laboratory results.

On 3 August 2012, Greece reported a probable case of dengue infection in a resident in west Greece (Agrinio). This case was classified as a probable dengue case due to the presence of a high titre of IgM dengue antibodies in a serum sample which would indicate an acute infection. In addition, dengue NS1 antigen was detected in serum with PCR, but detection of dengue nucleic acid tests was negative.

Additional laboratory investigations have now discarded this case as a dengue infection. This has been concluded as a rare occurrence of a cross-reaction with murine monoclonal antibodies used in both the IgM antibodies and NS1 antigen testing kits.

In the context of the response to the possible case, the Hellenic Centre for Disease Control (KEELPNO) performed epidemiological and entomological investigations.

The epidemiological investigation included active retrospective and prospective case finding, review of compatible cases, and a survey of people living within a 200m radius of the case and the patient?s relatives. A total of 132 patients were examined.

Ten reported compatible symptoms (such as fever, headache, arthralgias/myalgias, nausea, vomiting or Upper Respiratory Infection in the last 15 days) but all tested negative for IgM and IgG antibodies for dengue virus.

Two entomological missions were organized in the geographical area of possible infection, to investigate the presence of competent dengue virus vectors. Aedes albopictus adults were captured but tested negative for dengue virus.

Dengue is a mosquito-borne disease caused by any one of the four types of dengue virus. Most infections occur in tropical regions with an estimated 50 to 100 million infections annually in 125 countries. There is no direct person-to-person transmission. The main vector of dengue worldwide, the Aedes aegypti mosquito, is not present in Greece. Aedes albopictus, an effective secondary mosquito vector known to cause outbreaks, has been present in western Greece since at least 2003.

Dengue infections are rare in Europe and most cases are imported as a result of infection in tropical areas. Local transmission of dengue virus is extremely rare in Europe. The last recorded local transmission of dengue in Greece was during an outbreak in 1927 ? 1928, involving the Aedes aegypti mosquito.


In 2010, autochthonous cases of dengue were reported in France and Croatia in areas infested by Aedes albopictus.
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